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Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia

Meng Zhang1,2, Jun Tang3,2, Yang He1,2

  • 1Department of Pediatrics, Sichuan University West China Second University Hospital, Chengdu, China.

BMJ Open
|January 20, 2021
PubMed

Insights

This systematic review found that current neonatal hyperbilirubinemia guidelines vary in quality and recommendations. Future guidelines need improved development rigor and standardized treatment thresholds for better infant care.

Area of Science:

  • Neonatal Medicine
  • Clinical Practice Guidelines
  • Evidence-Based Medicine

Background:

  • Neonatal hyperbilirubinemia is a common clinical issue requiring high-quality guidelines.
  • Existing guidelines show variability in quality and recommendations across regions.
  • Standardized, implementable guidelines are crucial for improving patient outcomes.

Purpose of the Study:

  • To systematically assess the quality of neonatal hyperbilirubinemia guidelines using the AGREE-II instrument.
  • To summarize specific recommendations for neonatal hyperbilirubinemia diagnosis and management.
  • To provide suggestions for future guideline development.

Main Methods:

  • Systematic review of clinical practice guidelines.
  • Searched PubMed, Embase, Medline, and guideline databases.
  • Assessed 12 guidelines using the AGREE-II instrument by four independent appraisers.

Main Results:

  • The 12 appraised guidelines scored between 36%-89% overall.
  • Guidelines scored highest in clarity of presentation and lowest in rigor of development.
  • Diagnostic recommendations were mostly consistent; treatment thresholds and pharmacotherapy recommendations varied.

Conclusions:

  • Current guidelines exhibit variability in development quality and recommendations.
  • Future guidelines require enhanced methodological rigor.
  • More evidence is needed to standardize treatment initiation thresholds for neonatal hyperbilirubinemia.
Abstract

Keywords:
developmental neurology & neurodisabilityneonatologyprotocols & guidelines

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